Post-lumbar puncture headache: an adverse effect in multiple sclerosis work-up

Neurol Sci. 2019 Apr;40(4):759-762. doi: 10.1007/s10072-019-3724-z. Epub 2019 Jan 21.

Abstract

Background: Lumbar puncture (LP) is a safe procedure commonly performed in the diagnostic work-up of multiple sclerosis (MS), and its main adverse event is post-LP headache (PLPH). Predictors for PLPH in MS are not established.

Aims: To describe the occurrence of, and, factors related to PLPH in patients with suspected MS, studied on a daily-basis admission.

Patients and methods: One hundred patients (70 females) were admitted for a diagnostic LP (standardized with a traumatic 19-G needle), observed for 6 h, and evaluated for adverse events 2 and 7 days later. Descriptive statistics and a multivariate analysis (for PLPH) were performed.

Results: Fifty-seven (57%) patients had PLPH at 48 h, which persisted 1 week in 31, and only two presented beyond the first 2 days. Other adverse events were tinnitus and neck stiffness. None required investigations or was hospitalized. Age was the only predictor for PLPH at day 2, whereas the onset of headache within 48 h and female gender were predictors for PLPH at day 7.

Conclusion: PLPH is a frequent complication of LP performed on daily-basis admission in MS work-up. The maximum onset is within the first 48 h. Age and gender seem the only predictors for the appearance and persistence of PLPH.

Keywords: Diagnostic work up; Headache; Lumbar puncture; Multiple sclerosis.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / diagnosis*
  • Post-Dural Puncture Headache / etiology*
  • Sex Factors
  • Spinal Puncture / adverse effects*
  • Spinal Puncture / statistics & numerical data*
  • Young Adult